The SRA Symposium - College of Medicine

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ted on patients at l’Hopital St.-Louis in 1859 (Dracobly, 2003).
Louis Pasteur is perhaps more renowned for his discovery of the process of pasteurization, anaerobic
life, the process of fermentation, and development of the scientific method. He also discovered
a method to attenuate virulent microorganisms. In 1885, he successfully inoculated a nine-year
old boy named Joseph Meister, who was bitten multiple times by a rabid dog, with rabies vaccine
and in so doing, saved his life. He also developed treatments for chicken cholera and anthrax in
cattle.
Some of the above research continues to be controversial, as is the use of data collected from them.
Significantly, research that was instrumental in developing successful treatments for a human
disease has received little adverse press.
Human Subjects Protections
Pre-World War II
So far there has been little distinction between medical ethics and research ethics. It is a fine line,
one profiled in Bernard’s comment about hospitals as the place where physicians (and researchers)
make their observations. As mentioned earlier, medical advances (especially before the early days
of the scientific revolution in the late eighteenth century) depended on observations of human
diseases and experiments with patients. Evans and Beck note that each generation views life—and
medicine and research—through a different lens. What is commonplace in one century is frequently
decadent, indecent, or immoral in another. It is also worth noting that many experiments
were and remain controversial.
The distinction between therapeutic and nontherapeutic research merits distinction. Even though
they used children and slaves, Jenner, Pasteur, and Sims were conducting therapeutic research;
Cleopatra and Hansen were not. In therapeutic research, the patient might realistically benefit
from the experimental intervention. Prior to World War II, nontherapeutic research was not extensive
and there was consequently little concern over the ethical aspects of research with humans.
It is important to recognize that social and behavioral research was essentially nonexistent until
the middle years of the nineteenth century. Thus human subject research almost always dealt with
treating an injury or a disease.
Although early research with humans was almost invariably clinical in nature, Davies suggests that
Mary Shelley’s Frankenstein is an early research ethics text. He contends that Shelley was familiar
with electricity experiments and wrote the novel for its shock value. In her narrative, however, she
discusses how the scientist can become so thrilled with his work, so caught up by the science, so
excited by success, that he loses his moral perspective. Davies notes that future ethicists have “recognized
that the researcher’s ethical standards are probably the research subject’s most important
protection against harm.”
The basic principles of the Belmont Report are, according to Aksoy and Tenik, embodied in the
work of a thirteenth century Sufi scholar named Mawlana Jalaladdin Rumi (1207-1253). His writings
discuss the ways to a more harmonious life: autonomy, beneficence, non-maleficence, and
justice. Although Mawlana’s attention is not directed at research (or by extension human subjects
of medical experimentation), his writings presage the universal concerns of modern bioethical
concerns.
The earliest “modern” comment specifically about research ethics appears in Wilcock’s 1830 Laws
Relating to the Medical Profession: “When an experiment is performed with the consent of the
party subjected to it after he has been informed that it is an experiment, the practitioner is answer-
198 2005 Symposium Proceedings Book